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Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection
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  • Johnathan Khusid,
  • Adan Z. Becerra ,
  • Blair Gallante ,
  • Areeba S. Sadiq,
  • William M. Atallah,
  • Ketan K. Badani,
  • Mantu Gupta
Johnathan Khusid
Icahn School of Medicine at Mount Sinai
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Adan Z. Becerra
Rush University Medical Center
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Blair Gallante
Icahn School of Medicine at Mount Sinai
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Areeba S. Sadiq
Icahn School of Medicine at Mount Sinai
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William M. Atallah
Icahn School of Medicine at Mount Sinai
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Ketan K. Badani
Icahn School of Medicine at Mount Sinai
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Mantu Gupta
Icahn School of Medicine at Mount Sinai
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Abstract

Background: To evaluate COVID19 patients treated within our academic medical system to determine if history of malignancy, both in general and specifically in genitourinary oncology patients, is associated with adverse clinical outcomes, including AKI and mortality. Methods: We conducted a retrospective cohort study among patients with confirmed SARS-CoV-2 infection in a multi-hospital, academic medical institution in New York City. Outcomes included mortality, ICU admission and AKI among hospitalized patients. We also evaluated risk of hospitalization among all patients with SARS-CoV-2 infection. Multilevel logistic regression models were used for analysis. Results: We identified 6,893 patients who met inclusion criteria, of which 4,018 were hospitalized. Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%) experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds of death compared to those without cancer and this appeared to be driven by lung cancer (OR= 2.44, 95% CI= 1.05, 4.39). Patients with a history of genitourinary cancer were not at higher risk of mortality compared to those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer was not associated with ICU admission or AKI in overall and subgroup analyses. Conclusions: Patients with a history of cancer who are hospitalized with SARS-CoV-2 infection are not at greater risk for AKI, though they are at higher risk for mortality as compared to patients without a history of cancer. The increased risk in mortality appears driven by patients with pulmonary neoplasms. Patients with a history of genitourinary malignancies do not appear to be at higher risk for AKI or for mortality compared to the general population.

Peer review status:UNDER REVIEW

15 Sep 2020Submitted to International Journal of Clinical Practice
15 Sep 2020Assigned to Editor
15 Sep 2020Submission Checks Completed
18 Sep 2020Reviewer(s) Assigned